tbuckley/cabot-search huggingface dataset:
Good News for Toddlers with Peanut Allergy
Authors: Alkis Togias
Journal: New England Journal of Medicine (2023)

In this issue of the Journal, Greenhawt and colleagues report the findings of the EPITOPE (Epicutaneous Immunotherapy in Toddlers with Peanut Allergy) trial, a phase 3, multinational, double-blind, randomized, placebo-controlled trial of Viaskin Peanut 250 μg, a patch that delivers peanut protein to the skin to desensitize young children with peanut allergy.1 The trial, which involved toddlers 1 to 3 years of age, met its clinical end points, and the product, if approved, could eventually be used in this population. The primary finding is that after receiving treatment with the peanut patch for a year, 67.0% of the toddlers in . . .
Modifiable Mechanical Ventilation Targets Are Associated With Improved Survival in Ventilated VA-ECLS Patients
Authors: Aniket S. Rali, Lena E. Tran, Bryan Auvil, Meng Xu, Shi Huang, Lyana Labrada, Kelly H. Schlendorf, Matthew D. Bacchetta, Ashish S. Shah, Antonio Hernandez, JoAnn Lindenfeld
Journal: JACC Heart Failure (2023)
Advances in Coronary Computed Tomographic Angiographic Imaging of Atherosclerosis for Risk Stratification and Preventive Care
Authors: Solomon Bienstock, Fay Lin, Ron Blankstein, Jonathon Leipsic, Rhanderson Cardoso, Amir Ahmadi, Annetine Gelijns, Krishna Patel, Lauren A. Baldassarre, Michael Hadley, Gina LaRocca, Javier Sanz, Jagat Narula, Y.S. Chandrashekhar, Leslee J. Shaw, Valentin Fuster
Journal: JACC. Cardiovascular imaging (2023)
Coronary CT Angiography as a Guide to Timing of Invasive Treatment in Patients With NSTEACS
Authors: Jørgen T. Kühl, Henning Kelbæk, Jesper J. Linde, Per E. Sigvardsen, Thomas F. Hansen, Martina C. de Knegt, Merete Heitmann, Peter R. Hansen, Dan Høfsten, Lia E. Bang, Jens D. Hove, Charlotte Kragelund, Jawdat Abdulla, Lene Holmvang, Christian Torp-Pedersen, Gunnar Gislason, Thomas Engstrøm, Lars V. Køber, Klaus F. Kofoed
Journal: JACC. Cardiovascular imaging (2023)
The contribution of the exposome to the burden of cardiovascular disease
Authors: Thomas Münzel, Mette Sørensen, Omar Hahad, Mark Nieuwenhuijsen, Andreas Daiber
Journal: Nature Reviews Cardiology (2023)

Large epidemiological and health impact assessment studies at the global scale, such as the Global Burden of Disease project, indicate that chronic non-communicable diseases, such as atherosclerosis and diabetes mellitus, caused almost two-thirds of the annual global deaths in 2020. By 2030, 77% of all deaths are expected to be caused by non-communicable diseases. Although this increase is mainly due to the ageing of the general population in Western societies, other reasons include the increasing effects of soil, water, air and noise pollution on health, together with the effects of other environmental risk factors such as climate change, unhealthy city designs (including lack of green spaces), unhealthy lifestyle habits and psychosocial stress. The exposome concept was established in 2005 as a new strategy to study the effect of the environment on health. The exposome describes the harmful biochemical and metabolic changes that occur in our body owing to the totality of different environmental exposures throughout the life course, which ultimately lead to adverse health effects and premature deaths. In this Review, we describe the exposome concept with a focus on environmental physical and chemical exposures and their effects on the burden of cardiovascular disease. We discuss selected exposome studies and highlight the relevance of the exposome concept for future health research as well as preventive medicine. We also discuss the challenges and limitations of exposome studies. In this Review, Münzel and colleagues describe the exposome concept with a focus on environmental physical and chemical exposures and their effects on the burden of cardiovascular disease. Additionally, they discuss selected exposome studies and the relevance of the exposome concept for future health research and preventive medicine.
GAD Antibodies in Women With Hyperglycemia in Pregnancy: No Association With Large-for-Gestational-Age Birth Weight
Authors: Elhadji Mamadou Moussa Thioye, Eric Vicaut, Etienne Larger, Meriem Sal, Sara Pinto, Narimane Berkane, Emmanuelle Fabre, Yoann Lalatonne, Angela Sutton, Charlotte Nachtergaele, Jean-Jacques Portal, Lionel Carbillon, Hélène Bihan, Emmanuel Cosson
Journal: Diabetes Care (2023)

Hyperglycemia in pregnancy (HIP) in women with no known diabetes before pregnancy includes gestational diabetes mellitus and diabetes in pregnancy, which is defined as a glycemic level similar to that for diabetes outside pregnancy (1).Type 1 diabetes may be discovered during pregnancy, and one way to screen for it is to evaluate the presence of b-cell-specific autoantibodies.Up to 10% of women with HIP have these autoantibodies (2).As type 1 diabetes is associated with a very high rate of large-forgestational-age (LGA)-birth-weight infants (i.e., 44% in France [3]), we hypothesized that women with HIP and GAD antibodies (GADAs) may have a higher prevalence of LGA-birth-weight infants than women with HIP but no GADAs because of higher glucose levels during pregnancy and a decrease in insulin secretion (4).In this context, we investigated through a multiethnic, observational, prospective cohort whether HIP pregnancies had a poorer prognosis in terms of LGA infants according to different GADA categories, after adjusting for confounders.
Sex Differences in Prognosis of Heart Failure Due to Chronic Chagas Cardiomyopathy
Authors: Antonio P. Mansur, Antonio C. Pereira-Barretto, Carlos Henrique del Carlo, Barbara M. Ianni, Solange D. Avakian, Gustavo H.F. Gonçalinho, Naomi K. Nakagawa, Luiz A.M. César, Edimar A. Bocchi
Journal: JACC Heart Failure (2023)
Cabozantinib plus Nivolumab and Ipilimumab in Renal-Cell Carcinoma
Authors: Toni K. Choueiri, Thomas Powles, Laurence Albiges, Mauricio Burotto, Cezary Szczylik, Bogdan Zurawski, Eduardo Yanez Ruiz, Marco Maruzzo, Alberto Suarez Zaizar, Luis E. Fein, Fabio A. Schutz, Daniel Y.C. Heng, Fong Wang, Fabio Mataveli, Yu-Lin Chang, Maximiliano van Kooten Losio, Cristina Suarez, Robert J. Motzer
Journal: New England Journal of Medicine (2023)

The efficacy and safety of treatment with cabozantinib in combination with nivolumab and ipilimumab in patients with previously untreated advanced renal-cell carcinoma are unknown.
Transoral endoscopic thyroidectomy vestibular approach as a safe and feasible alternative to open thyroidectomy: a systematic review and meta-analysis
Authors: Moon Young Oh, Young Jun Chai, Hyeong Won Yu, Su-Jin Kim, June Young Choi, Kyu Eun Lee
Journal: International Journal of Surgery (2023)

Background: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a scarless alternative to open thyroidectomy (OT). This systematic review and meta-analysis aimed to synthesize evidence comparing the intraoperative and postoperative outcomes of TOETVA and OT. Methods: A systematic literature search of PubMed, Web of Science, the Cochrane Library, and Google Scholar was performed to identify studies comparing the outcomes of TOETVA and OT published before February 2023. The outcomes of interest were operative time, intraoperative blood loss, hospital stay, postoperative pain, number of central lymph nodes retrieved, number of metastatic central lymph nodes, and incidences of transient and permanent recurrent laryngeal nerve injury, transient and permanent hypocalcemia, hematoma, and infection. Results: Thirteen studies published between 2016 and 2022, involving a total of 2889 patients (TOETVA, n =1085; OT, n =1804) were included in this systematic review and meta-analysis. Meta-analysis showed that the TOETVA group had a significantly longer overall operative time (weighted mean difference [WMD] 55.19; 95% CI, 39.15, 71.23; P &lt;0.001), longer hospital stay (WMD, 0.27; 95% CI, 0.14, 0.39; P &lt;0.001), and lower pain scores on postoperative day 1 (WMD, −1.41; 95% CI, −2.79, −0.03; P =0.04) than the OT group. Other intraoperative and postoperative outcomes were not significantly different between the groups. Conclusion: TOETVA has a similar safety profile to OT with less postoperative pain, making it an appropriate and more cosmetically appealing alternative to OT for select patients.
Postoperative infectious complications following laparoscopic versus open hepatectomy for hepatocellular carcinoma: a multicenter propensity score analysis of 3876 patients
Authors: Jia-Le Pu, Xiao Xu, Lan-Lan Chen, Chao Li, Hang-Dong Jia, Zhong-Qi Fan, Ju-Dong Li, Ming-Cheng Guan, Ying-Jian Liang, Ya-Hao Zhou, Xian-Ming Wang, Wei-Min Gu, Hong Wang, Jie Li, Zhi-Yu Chen, Ting-Hao Chen, Yao-Ming Zhang, Zi-Xiang Chen, Lan-Qing Yao, Yong-Kang Diao, Ming-Da Wang, Feng Shen, Timothy M. Pawlik, Wan Yee Lau, Zhong Chen, Tian Yang, Guo-Yue Lv
Journal: International Journal of Surgery (2023)

Hepatocellular carcinoma (HCC) is a common indication for hepatectomy that is often complicated by postoperative complication. The authors sought to investigate the relationship between the open with laparoscopic approach of hepatectomy and incidences of postoperative infectious complications.Using a multicenter database, HCC patients who underwent laparoscopic hepatectomy (LH) or open hepatectomy (OH) were reviewed and analyzed. Propensity score matching (PSM), inverse probability of treatment weight (IPTW), and multivariate logistic regression analyses were utilized to assess the association of the operative approach with postoperative infectious complications, including incisional surgical site infection (SSI), organ/space SSI, and remote infection (RI).Among 3876 patients, 845 (21.8%) and 3031 (78.2%) patients underwent LH and OH, respectively. The overall incidence of infection was 6.9 versus 14.6% among patients who underwent LH versus OH, respectively ( P <0.001). Of note, the incidences of incisional SSI (1.8 vs. 6.3%, P <0.001), organ/space SSI (1.8 vs. 4.6%, P <0.001), and RI (3.8 vs. 9.8%, P <0.001) were all significantly lower among patients who underwent LH versus OH. After PSM (6.9, 1.8, 1.8, and 3.8% vs. 18.5, 8.4, 5.2, and 12.8%, respectively) and IPTW (9.5, 2.3, 2.1, and 5.5% vs. 14.3, 6.3, 4.5, and 9.8%, respectively), LH remained associated with statistically lower incidences of all types of infectious complications. After adjustment for other confounding factors on multivariate analyses, LH remained independently associated with lower incidences of overall infection, incisional SSI, organ/space SSI, and RI in the overall, PSM, and IPTW cohorts, respectively.Compared with open approach, laparoscopic approach was independently associated with lower incidences of postoperative infectious complications following hepatectomy for HCC.
Letter to the Editor: Is there survival bias? The etiologic analysis for the negative association between fatty liver and mortality in the elderly populations
Authors: Yue Hu, Zheng Li, Weilan He, Xin Wang, Xinran Cheng
Journal: Hepatology (2023)

To the editor, With great interest, we read the prospective cohort study by van Kleef et al1 published in Hepatology in February 2023. A novel no-association between fatty liver disease (FLD) and increased mortality was found in the elderly (≥65 y old) by this large, prospective, population-based cohort study.1,2 The authors mentioned potential survival bias (PSB) in the fourth paragraph of discussion, and they have tried to find some logical explanations for the PSB of the negative association.1 However, the etiology analysis of FLD was missing for this issue, which may open a new door to explain the PSB of the present negative association. What is the possible reason for the aforementioned PSB from etiology? In terms of etiology, FLD could be caused by some different etiologic categories, such as HBV, HCV, excess alcohol intake, obesity, diabetes, and other metabolic dysfunction diseases (Figure 1). Different pathogenesis may result in different risk and age distribution of mortality (Figure 1). Accordingly, some etiologic types of FLD with high mortality (eg, metabolic dysfunction-associated FLD) could lead into PSB for the aforesaid no-association in elderly populations because of the specific deaths at younger ages.1,3 There is a possibility that the etiologic types of FLD in elderly populations are associated with very low risk of mortality, which is difficult to detect. There is another possibility that no association between FLD and mortality exists in some elderly populations with specific etiologic types of FLD.FIGURE 1: Etiologic analysis for the potential survival bias of the negative association between FLD and mortality in the elderly populations. Abbreviation: MAFLD, metabolic associated fatty liver disease.Collectively, to fully clarify the PSB of the no association between FLD and mortality in the elderly, it is necessary to perform the etiologic analysis of FLD and to calculate the different age distribution of mortality caused by different types of FLD.
Comparisons of different new-generation transcatheter aortic valve implantation devices for patients with severe aortic stenosis: a systematic review and network meta-analysis
Authors: Yi-Xing Yang, Xin-Ming Liu, Yuan Fu, Chuang Li, Hong-Jiang Wang, Li Xu, Kun Xia, Zhi-Yong Zhang, Jiu-Chang Zhong, Mu-Lei Chen, Pi-Xiong Su, Le-Feng Wang
Journal: International Journal of Surgery (2023)

Background: Whether there are differences among the new-generation transcatheter aortic valve implantation (TAVI) devices for patients with aortic stenosis remains unclear. The aim of the study was to compare the efficiency and safety of different new-generation TAVI devices for patients with aortic stenosis. Materials and methods: A comprehensive search of PubMed, Embase and Web of Science from their inception to 1 February 2022. Randomized clinical trials and observational studies that compared two or more different TAVI devices were enroled. Pairwise meta-analysis and frequentist network meta-analysis were conducted to pool the outcome estimates of interest. Results: A total of 79 studies were finally included. According to the surface under the cumulative ranking, the top two ranked valves for lower rates of events were as follows: direct flow medical (DFM) (4.6%) and Lotus (48.8%) for lower rate of device success; Sapien 3 (16.8%) and DFM (19.7%) for lower mortality; DFM (8.6%) and Sapien 3 (25.5%) for lower rates of stroke; Evolut (27.6%) and DFM (35.8%) for lower rates of major and life-threatening bleeding; Portico (22.6%) and Sapien 3 (41.9%) for lower rates of acute kidney injury; Acurate (8.6%) and DFM (13.2%) for lower rates of permanent pacemaker implantation; Lotus (0.3%) and Sapien 3 (22.7%) for lower rates of paravalvular leak; Evolut (1.4%) and Portico (29.1%) for lower rates of mean aortic valve gradients. Conclusions: The findings of the present study suggested that the device success rates were comparable among these new-generation valves except for DFM. After excluding DFM, Sapien 3 might be the best effective for decreased mortality and stroke; Lotus might be the best effective for decreased paravalvular leak; Evolut might be the best effective for decreased major and life-threatening bleeding and mean aortic valve gradients; Acurate and Portico might be the best effective for decreased permanent pacemaker implantation and acute kidney injury, respectively.
Tropifexor plus cenicriviroc combination versus monotherapy in nonalcoholic steatohepatitis: Results from the phase 2b TANDEM study
Authors: Quentin M. Anstee, Kathryn J. Lucas, Sven Francque, Manal F. Abdelmalek, Arun J. Sanyal, Vlad Ratziu, Adrian C. Gadano, Mary Rinella, Michael Charlton, Rohit Loomba, Edward Mena, Jörn M. Schattenberg, Mazen Noureddin, Donald Lazas, George B.B. Goh, Shiv K. Sarin, Yusuf Yilmaz, Miljen Martic, Rowan Stringer, Jossy Kochuparampil, Li Chen, Gerardo Rodriguez-Araujo, Elaine Chng, Nikolai V. Naoumov, Clifford Brass, Marcos C. Pedrosa
Journal: Hepatology (2023)

Background and Aims: With distinct mechanisms of action, the combination of tropifexor (TXR) and cenicriviroc (CVC) may provide an effective treatment for NASH. This randomized, multicenter, double-blind, phase 2b study assessed the safety and efficacy of TXR and CVC combination, compared with respective monotherapies. Approach and Results: Patients (N = 193) were randomized 1:1:1:1 to once-daily TXR 140 μg (TXR 140 ), CVC 150 mg (CVC), TXR 140 μg + CVC 150 mg (TXR 140 + CVC), or TXR 90 μg + CVC 150 mg (TXR 90 + CVC) for 48 weeks. The primary and secondary end points were safety and histological improvement, respectively. Rates of adverse events (AEs) were similar across treatment groups. Pruritus was the most frequently experienced AE, with highest incidence in the TXR 140 group (40.0%). In TXR and combination groups, alanine aminotransferase (ALT) decreased from baseline to 48 weeks (geometric mean change: −21%, TXR 140 ; −16%, TXR 140 + CVC; −13%, TXR 90 + CVC; and +17%, CVC). Reductions in body weight observed at week 24 (mean changes from baseline: TXR 140 , −2.5 kg; TXR 140 + CVC, −1.7 kg; TXR 90 + CVC, −1.0 kg; and CVC, −0.1 kg) were sustained to week 48. At least 1-point improvement in fibrosis stage/steatohepatitis resolution without worsening of fibrosis was observed in 32.3%/25.8%, 31.6%/15.8%, 29.7%/13.5%, and 32.5%/22.5% of patients in the TXR 140 , CVC, TXR 140 + CVC, and TXR 90 + CVC groups, respectively. Conclusions: The safety profile of TXR + CVC combination was similar to respective monotherapies, with no new signals. TXR monotherapy showed sustained ALT and body weight decreases. No substantial incremental efficacy was observed with TXR + CVC combination on ALT, body weight, or in histological end points compared with monotherapy.
The status of psychodynamic psychotherapy as an empirically supported treatment for common mental disorders – an umbrella review based on updated criteria
Authors: Falk Leichsenring, Allan Abbass, Nikolas Heim, John R. Keefe, Steve Kisely, Patrick Luyten, Sven Rabung, Christiane Steinert
Journal: World Psychiatry (2023)

To assess the current status of psychodynamic therapy (PDT) as an empirically supported treatment (EST), we carried out a pre-registered systematic umbrella review addressing the evidence for PDT in common mental disorders in adults, based on an updated model for ESTs. Following this model, we focused on meta-analyses of randomized controlled trials (RCTs) published in the past two years to assess efficacy. In addition, we reviewed the evidence on effectiveness, cost-effectiveness and mechanisms of change. Meta-analyses were evaluated by at least two raters using the proposed updated criteria, i.e. effect sizes, risk of bias, inconsistency, indirectness, imprecision, publication bias, treatment fidelity, and their quality as well as that of primary studies. To assess the quality of evidence we applied the GRADE system. A systematic search identified recent meta-analyses on the efficacy of PDT in depressive, anxiety, personality and somatic symptom disorders. High quality evidence in depressive and somatic symptom disorders and moderate quality evidence in anxiety and personality disorders showed that PDT is superior to (inactive and active) control conditions in reducing target symptoms with clinically meaningful effect sizes. Moderate quality evidence suggests that PDT is as efficacious as other active therapies in these disorders. The benefits of PDT outweigh its costs and harms. Furthermore, evidence was found for long-term effects, improving functioning, effectiveness, cost-effectiveness and mechanisms of change in the aforementioned disorders. Some limitations in specific research areas exist, such as risk of bias and imprecision, which are, however, comparable to those of other evidence-based psychotherapies. Thus, according to the updated EST model, PDT proved to be an empirically-supported treatment for common mental disorders. Of the three options for recommendation provided by the updated model (i.e., "very strong", "strong" or "weak"), the new EST criteria suggest that a strong recommendation for treating the aforementioned mental disorders with PDT is the most appropriate option. In conclusion, PDT represents an evidence-based psychotherapy. This is clinically important since no single therapeutic approach fits all psychiatric patients, as shown by the limited success rates across all evidence-based treatments.
Organ preservation strategies after neoadjuvant chemoimmunotherapy in resectable non-small cell lung cancer: a multicenter retrospective cohort study
Authors: Bengang Hui, Xun Wang, Xin Wang, Bowei Qiao, Jiangnan Duan, Rongxin Shang, Weibo Yang, Jun Wang, Kezhong Chen, Fan Yang, Tao Jiang, Jie Lei
Journal: International Journal of Surgery (2023)

Neoadjuvant chemoimmunotherapy has shown a good therapeutic effect on non-small cell lung cancer (NSCLC), which also opens up the possibility of applying organ preservation strategies. This study investigated the feasibility of modified surgery after potent neoadjuvant chemoimmunotherapy in central type NSCLC.In this multicenter retrospective cohort study, patients with central type NSCLC who received 2-4 cycles of neoadjuvant chemoimmunotherapy between January 2019 and June 2022 at Air Force Medical University Tangdu Hospital and Peking University People's Hospital were eligible. Patients were divided into modified and nonmodified groups according to the extent of surgery, after which, the safety and long-term prognosis of surgery were investigated.A total of 84 patients were enrolled. Of 36 (42.9%) patients who underwent modified surgery, 21 patients underwent lobectomy, 12 patients underwent lobectomy with bronchoplasty, 2 patients underwent sleeve lobectomy, and 1 patient underwent bilobectomy. The modification rate for the initially estimated pneumonectomy, sleeve lobectomy, and bilobectomy was 48.6, 44.8, and 30%, respectively. Grades II-V postoperative complications were found in 5 (13.9%) patients in the modified group and 17 (35.4%) patients in the nonmodified group (relative risk, 0.393; 95% CI, 0.016-0.963; P =0.026). No significant difference was observed regarding the surgical approach, operative duration, blood loss, or R0 resection rate. The 2-year local recurrence rate was 3.7% (95% CI, 0.004-0.175) and 5.2% (95% CI, 0.012-0.168) in the modified group and nonmodified group, respectively. The 1-year PFS rate of modified and nonmodified groups was 97.1% (95% CI, 83.7-99.8) and 86.9% (95% CI, 73.4-94.4), respectively, while 2-year PFS were 89.8% (95% CI, 74.1-96.9) and 71.8% (95% CI, 56.7-83.4), respectively.Applying organ preservation strategies, that is, undergoing modified surgery after neoadjuvant chemoimmunotherapy, is feasible for selected central type NSCLC patients with favorable safety and long-term survival.